scholarly journals Platypnea–orthodeoxia syndrome in a postoperative patient: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
João Pinto Pereira ◽  
Benoit Ghaye ◽  
Pierre-François Laterre ◽  
Philippe Hantson
Keyword(s):  
Pulmonary Embolism ◽  
Pleural Effusion ◽  
Oxygen Saturation ◽  
Venous Return ◽  
Central Venous Line ◽  
Bilateral Pleural Effusion ◽  
Arterial Oxygen ◽  
Arterial Line ◽  
Central Venous ◽  
Anomalous Pulmonary Venous Return

Abstract Background We report a case of platypnea–orthodeoxia syndrome observed in a complex clinical situation associating a bilateral pleural effusion, lobar pulmonary embolism, and a partial anomalous pulmonary venous return. Case presentation A 57-year-old Caucasian woman developed acute dyspnea in the postoperative course of an elective gynecological surgery for advanced stage ovarian cancer. Preoperative evaluation had failed to reveal any respiratory or cardiac problem. After evidence of a low arterial oxygen saturation, blood gas analysis from the central venous line correctly inserted in the right internal jugular vein revealed a higher oxygen saturation than in the arterial compartment. A thoracic computed tomography showed bilateral pleural effusion, lobar pulmonary embolism, and a drainage of a left pulmonary vein into the left innominate vein. This unique combination resulted in an uncommon cause of platypnea–orthodeoxia syndrome. Conclusion Often associated with right-to-left shunting, platypnea–orthodeoxia syndrome may be observed in complex clinical conditions with several factors influencing the ventilation/perfusion ratio. The paradoxical finding of a higher oxygen saturation in a central venous line than in an arterial line should prompt the clinician to look at the possibility of partial anomalous pulmonary venous return. No specific treatment is required in asymptomatic adults, except for an echocardiographic follow-up to detect the onset of pulmonary hypertension.

scholarly journals Central Venous Line Insertion Revealing Partial Anomalous Pulmonary Venous Return: Diagnosis and Management

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Bashar Alzghoul ◽  
Ayoub Innabi ◽  
Aditya Chada ◽  
Ahmad R. Tarawneh ◽  
Krishna Kakkera ◽  
...  
Keyword(s):  
Systematic Approach ◽  
Unusual Case ◽  
Venous Return ◽  
Central Venous Line ◽  
Central Venous ◽  
Diagnosis And Management ◽  
Line Insertion ◽  
Anomalous Pulmonary Venous Return ◽  
Anomalous Pulmonary Vein ◽  
Unusual Situation

Central venous line malposition is a well-known complication of line insertion. Rarely, it can be mal-positioned in an anomalous pulmonary vein. We present an unusual case of a 56-year-old woman that was found to have partial anomalous pulmonary venous return on central venous line insertion. In this report, we describe a systematic approach to diagnosis and management of this unusual situation.

Clinical relevance of bilateral pleural effusion in patients with acute pulmonary embolism

2020 ◽  
Vol 50 (8) ◽  
pp. 938-944
Author(s):  
Ofer Levy ◽  
Daniel Fux ◽  
Tetiana Bartsikhovsky ◽  
Sergei Vosko ◽  
Moshe Tishler ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pleural Effusion ◽  
Clinical Relevance ◽  
Acute Pulmonary Embolism ◽  
Bilateral Pleural Effusion

scholarly journals Tracking Arteriovenous Fistula Maturation: A Novel Approach

2018 ◽  
Vol 47 (1-3) ◽  
pp. 240-245 ◽  
Author(s):  
Laura M. Rosales ◽  
Hanjie Zhang ◽  
Marilou Mateo ◽  
Brenda Chan ◽  
Israel Campos ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Arteriovenous Fistula ◽  
Arterial Oxygen Saturation ◽  
Central Venous Oxygen Saturation ◽  
The United States ◽  
Upper Body ◽  
Arterial Oxygen ◽  
Central Venous ◽  
Hemodynamic Changes ◽  
Improvement Project

Background: The time between the creation of an arteriovenous fistula (AVF) and its successful use is significantly longer in hemodialysis (HD) patients in the United States compared to those in other countries, and there is an urgent need to reduce the residence time of central-venous catheters (CVC). Methods: Successful AVF creation and maturation results in typical hemodynamic changes, such as an increase in cardiac output and upper body blood flow (UBBF). In patients with CVC as vascular access, we measured once per minute intradialytic central-venous oxygen saturation (ScvO2) and hemoglobin levels simultaneously using the Crit-Line Monitor. Under conditions of stable upper body oxygen consumption and arterial oxygen saturation, ScvO2 and hemoglobin concentration allows the calculation of estimated UBBF (eUBBF). In a quality improvement project, we used ScvO2 and eUBBF to track the hemodynamic changes accompanying AVF maturation. Results: Out of 11 patients (9 incident to HD, 1 female, age 61 ± 13 years), AVF maturation was successful in 9. In 1 patient, the AVF did not mature. One patient died from sudden cardiac death with a maturing AVF. In the 9 patients with successful AVF maturation, ScvO2 increased from 60.9 ± 2.7% prior to AVF creation to 73.4 ± 3.6% a week after AVF creation (19.6 ± 6.3% increase). eUBBF increased from 1.3 ± 0.3 to 2.2 ± 0.6 L/min (62.7 ± 37.5% increase); no material ScvO2 or eUBBF changes occurred in the other 2 patients. Conclusion: Our results indicate the potential utility of ScvO2 and eUBBF to track the hemodynamic response to AVF maturation. To what extent these insights translate into shortening of the time between AVF creation and successful cannulation warrants further investigations.

The influence of intra-aortic balloon counter pulsation on central venous blood oxygen saturation

Perfusion ◽  
2021 ◽  
pp. 026765912110559
Author(s):  
Ayman Mohamed ◽  
Sameh Aboulnaga ◽  
Fayez Hamwi ◽  
Amr S Omar ◽  
Abdulrasheed Pattath ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Oxygen Saturation ◽  
Venous Blood ◽  
Blood Gases ◽  
Left Ventricular ◽  
Arterial Oxygen ◽  
Secondary Outcome ◽  
Central Venous ◽  
Significant Difference

Objectives We aim at identifying the changes in venous blood saturation values that associates intra-aortic balloon pump (IABP) in cardiac surgery patients with reduced left ventricular function (LVF). Methods A retrospective observational study was conducted in a cardiothoracic intensive care unit (CTICU) in a tertiary cardiac center over 5 years in Qatar. A total of 114 patients with at least moderate impairment of LVF with ejection fraction (EF) less than 40% were enrolled. According to the association of IABP, patients were segregated into two groups with and without IABP (groups 1, 40 patients and group 2, 74 patients). Sequential arterial and venous blood gases were analyzed. The primary outcome was to analyze the changes in the central venous saturation (ScvO2) in both groups and the secondary outcome was to analyze whether these changes affect the overall outcome in terms of intensive care unit (ICU) length of stay. Results There was no significant difference between both groups with regard to age, preoperative EF, hemoglobin, and arterial oxygen saturation (SaO2) in blood gases. Patients with IABP have a higher cScvO2 when compared to the other group (71.5 ± 12.5 vs 63.5 ± 9.3, 68.3 ± 12.6 vs 60.1 ± 9.5, 62.7 ± 10.8 vs 55.63 ± 8.1, and 60.6 ± 7.6 vs 54.9 ± 8.1; p = 0.04, 0.05, 0.03, and 0.5, respectively). However, generalized estimating equations (GEE) analysis showed that compared with the participants showing that there is a decreasing trend in mean levels within the groups during follow-ups, overall difference between both groups’ mean levels was not statistically significant. Conclusions In this study, we observed that after cardiac surgeries, patients with IABP had non-significant higher ScvO2 when compared with a corresponding group with moderate impairment of LVF. Further prospective studies are required to validate these findings.

Investigating spectroscopic measurement of sublingual veins and tissue to estimate central venous oxygen saturation

2021 ◽  
pp. 1-9
Author(s):  
Aslinur Sircan-Kucuksayan ◽  
Oktay Eray ◽  
Murat Buyukaksu ◽  
Birce Gumus ◽  
Oguz Dursun ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Near Infrared ◽  
Arterial Oxygen Saturation ◽  
Central Venous Oxygen Saturation ◽  
Arterial Oxygen ◽  
Central Venous ◽  
Venous Oxygen Saturation ◽  
Oxygenation Status

BACKGROUND: Venous oxygen saturation reflects venous oxygenation status and can be used to assess treatment and prognosis in critically ill patients. A novel method that can measure central venous oxygen saturation (ScvO2) non-invasively may be beneficial and has the potential to change the management routine of critically ill patients. OBJECTIVE: The study aims to evaluate the potential of sublingual venous oxygen saturation (SsvO2) to be used in the estimation of ScvO2. METHODS: We have developed two different approaches to calculate SsvO2. In the first one, near-infrared spectroscopy (NIRS) measurements were performed directly on the sublingual veins. In the second approach, NIRS spectra were acquired from the sublingual tissue apart from the sublingual veins, and arterial oxygen saturation was measured using a pulse oximeter on the fingertip. RESULTS: Twenty-six healthy subjects were included in the study. In the first and second approaches, average SsvO2 values were 75.0% ± 1.8 and 75.8% ± 2.1, respectively. The results of the two different approaches were close to each other and similar to ScvO2 of healthy persons (> 70%). CONCLUSION: Oxygen saturation of sublingual veins has the potential to be used in intensive care units, non-invasively and in real-time, to estimate ScvO2.

scholarly journals X-Ray of One-Sided “White Lung” after Central Venous Catheterization

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Michel Casanova ◽  
Wolfgang Ummenhofer
Keyword(s):  
Case Report ◽  
Pleural Effusion ◽  
Emergency Management ◽  
Central Venous Catheterization ◽  
Central Venous Line ◽  
Central Venous ◽  
X Ray ◽  
Venous Catheterization ◽  
Radiological Abnormality ◽  
Rule Out

Complications during insertion of a subclavian central venous line are rare but potentially serious. This case report describes the radiological abnormality of a one-sided pleural effusion during a routine control directly after a difficult central venous catheterization. We illustrate the findings, the initial emergency management, and our procedure to rule out an iatrogenic hemothorax. Possible differential diagnoses and strategies for management of a suspected complication are discussed.

Bilateral Pleural Effusion as a Complication of Central Venous Catheterization

2015 ◽  
Vol 16 (4) ◽  
pp. e80-e81
Author(s):  
Amira Masri ◽  
Asmaa Semrin ◽  
Tariq Abdelghani ◽  
Iyad Al-Ammouri
Keyword(s):  
Pleural Effusion ◽  
Central Venous Catheterization ◽  
Bilateral Pleural Effusion ◽  
Central Venous ◽  
Venous Catheterization

Effects of extracorporeal oxygenation of venous return on pulmonary artery pressure

1962 ◽  
Vol 202 (3) ◽  
pp. 510-514 ◽  
Author(s):  
William M. Chadduck
Keyword(s):  
Pulmonary Artery ◽  
Oxygen Saturation ◽  
Pulmonary Artery Pressure ◽  
Venous Return ◽  
Arterial Oxygen Saturation ◽  
Right Atrial ◽  
Arterial Oxygen ◽  
Artery Pressure ◽  
Pulmonary Arterial ◽  
Extracorporeal Oxygenation

Pulmonary arterial hyperoxemia was produced in anesthetized, open-chest dogs by means of an extracorporeal oxygenator with an inflow system which prevented right atrial pressure from exceeding 7–10 cm of blood. No significant changes in pulmonary artery pressure were found when pulmonary arterial oxygen saturation was elevated to 80–99%. The elevated pulmonary artery pressure associated with systemic arterial hypoxemia was reduced by extracorporeal oxygenation of venous return. The use of such a system for attainment of tolerable levels of systemic arterial oxygen saturation in patients with acute disorders of pulmonary alveolar-capillary gas exchange is discussed.

Pericardial and Pleural Effusion after Central Venous Line Insertion

2000 ◽  
Vol 8 (4) ◽  
pp. 372-374 ◽  
Author(s):  
Ehud Deviri ◽  
Oleg Avrutis ◽  
Shalom Friedman ◽  
Jack Meshoulam ◽  
Ohn Sibirsky ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Central Venous Line ◽  
Central Venous ◽  
Line Insertion

scholarly journals Aneurysms of the posterior circulation

2018 ◽  
Vol 3 (2) ◽  
pp. 49-58
Author(s):  
Fernando G. Diaz
Keyword(s):  
Perfusion Pressure ◽  
Medical Condition ◽  
Petrous Bone ◽  
Systemic Circulation ◽  
Central Venous Line ◽  
Posterior Circulation ◽  
Arterial Line ◽  
Careful Monitoring ◽  
Central Venous ◽  
Vertebrobasilar Circulation

The management of aneurysm in the vertebrobasilar circulation post difficult challanges in complex aproaches. The preparation of the patient should proceed with an initial thorough medical and neurlogical assement to establish a clear and trouble free pathway to the surgical procedure. A careful monitoring of hemodynamic properties of the systemic circulation, normalization of all cardiac function and optimization of medical condition is required. An arterial line, central venous line, a Swan-Ganz catheter, the recording of cardiac output, cardiac index, urinary output, and cerebral perfusion pressure are considered very important in the management of these patients. Different surgical alternatives including supratentorial approaches via the pterional or the subtemporal area, suboccipital approaches through a midline, lateral transmatoid or asterional approach and transbasilar approaches through the clivus, petrous bone or mastoid are descried. Risks and potential complications are reviewed and alternatives are discussed.

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